GRAND RAPIDS, MICHIGAN -- My employer assigned my family to blue cross/blue shield recently after being with another provider for 15 years. We had dropped blue cross/blue shield 15 years ago because of extreme incompetence in their billing and customer service. I had suffered a back injury that required a lot of procedures and rehab 15 years ago. Blue cross/blue shield couldn't process the bills that my approved doctors submitted and failed to enter the right billing codes, etc.., then proceeded to send the bills directly for me. Then came the late notices. Meanwhile, myself and the doctors worked to get it straightened out and the next thing that came in the mail were notices from Blue Cross/blue shield indicating the bills would be forwarded to a collection agency. That did it for me. The stress of dealing with this POS company was a negative factor in my healing process. It took about a year to straighten things out with these idiots, the whole time it took for my back to heal.

I think I would have healed faster if it wasn't for BCBS. Now, through no choice of my own, we are assigned again by my employer to this so-called health care provider. Earlier today I went to their website to register my new health card and set up an online account. Their site would not allow me to complete the registration so I called their toll free number. That's when the flashbacks of 15 years ago began. After going through their pathetically long menu, waiting and waiting and waiting, I talked to somebody for a few minutes, mostly answering inept questions and waiting, to find out she couldn't do anything. So she sends me off to somebody else. Same thing. After the 4th person, I finally got registered. The main problem was their system had a totally different id # than what is on my id card. Figure that out.

I then had a few questions about my coverage. She couldn't find the answers and transferred me to someone else. Same thing, so she gave me a phone number to call. I called it and after talking to 2 more people I was transferred back to the same people who gave me the phone #. The next person couldn't help me and suggested the phone # I had already been given and tried. I told her that phone number was not helpful. She then transferred me to somebody else. Same problem. I hung up, called customer service again and was finally talking to somebody, after much difficulty, who dug in a little deeper and found the simple answers I needed about the copay required for x-rays and MRI's, lab work, and surgical procedures. Nothing difficult. After all, they are a "healthcare" company, aren't they? Hardly. They're no more than a profiteering company with the word healthcare in their name. They are an incompetent organization that should be involved in something else than healthcare.

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Worse Experience of My Life.

Posted by Adrienne on 09/03/2014

Rating: 1/51

SAN ANTONIO, GEORGIA -- I applied on marketplace in Dec of 2013 for Insurance from 2 separate companies, one for medical and BCBS for dental. Within weeks I received information from my medical insurance, which I paid for. I never received anything from BCBS. I assumed that because I never received anything that they didn't get my application or I would get info in April because the deadline was set back.

I finally received information from them (a welcome packet, bill, and my BCBS dental card) in April. I paid my premium in May. After paying my premium I received a bill for $216.XX. I called BCBS to find out why I was being billed that amount. I was told that it was everything I owed them from Jan until present for coverage. I explained the situation only to have them tell me that they couldn't change the date on my insurance and I told them I wanted to cancel. Then I got a notice that said that my insurance had been canceled Feb 1, 2014.

I called to request a refund for the amount that I paid. The insurance was cancelled before I had ever paid it and the whole thing is a mistake with their system. I was told by a CSR that I should have never been allowed to pay for the insurance and that I should expect a refund check in 7 - 10 business days. That was July 21st. The lady gave me a reference number, her name, and her employee ID number. Today Sept 3rd, 2014 I called to find out where my refund was. I was told that the CSR should have never told me that I would be getting a refund and that the money I paid in May went to my Jan 2014 bill and that's why I got a letter saying I was canceled in Feb for non payment, which does not make any since what so ever.

After spending at least 4 hrs on the phone over a course of 3 months, I am being told I am not getting a refund and that I could appeal it if I wanted. So I paid for insurance I never had and BCBS is trying to keep my money and some how pinning their system errors on me. BCBS is a NIGHTMARE!

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Prescription Drug Coverage

Posted by G on 05/13/2013

Rating: 3/51

PHOENIX, ARIZONA -- Blue Cross/Blue Shield of AZ lists on their Prescription Benefits Web Page drugs covered. Even though Chantix is listed on their Covered Prescriptions my prescription was denied. After speaking with a representative at BCBS prescription Benefits, I was told that MY PLAN did not include a benefit for that prescription (smoking cessation products/devices). I asked why was it listed on the web under my prescription benefits? I was told that the majority of BCBS plans do not provide for smoking cessation products. With all of the anti-smoking campaigning that goes on these days, why on earth would a health insurance provider deny someone the opportunity to quit smoking? That is just ludicrous! It's time that insurance providers like BCBS get their act together and start providing people with the benefits that really count. I guess I will need to wait to get some type of cancer, since they WILL cover that! How STUPID is that! Blue Cross/Blue Shield it's time you stopped misrepresentation/misleading information posted on your web-site. Or at least get your tiny letter disclaimers correct "Coverage may vary by benefit plan". Maybe it should really read "This Item may not be covered under your plan." When you say "Coverage may vary by benefit plan" you are giving the false impression that benefit plans cover this item, but in some other degree. That's just like if you bought a box of waffles and on the box in very small print it said "Waffle count may vary by box."

So in some cases you get 12 waffles, other times you get 4 waffles and sometimes you get no waffles at all. Sounds like a sweet deal for the waffle maker but not for the consumer. Come on BCBS step up an do the right thing and start helping people that want the help, after all, you wouldn't exist without us.

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Nothing but trouble even before any claim ever filed

Posted by Jerry on 04/20/2013

Rating: 2/51

MASSACHUSETTS -- I joined BCBS on 12-7-12 during the enrollment period and selected the check box election to have premiums deducted from SSA benefits and immediately began getting premium bills for the $28 monthly cost. I called and was told auto-deduct would begin in March, and was given a confirmation number for the call/incident, but the paper bills kept coming so I called again and got a 2nd ref. # after hanging on my prepay cell phone for close to half an hour. The representative promised all would be well beginning in June. I then sent a double payment for the 2 month period til June. I then received another paper bill for a rate increase, completely unexplained, and another bill for a full month, plus the rate increase.

It seems that explaining anything to customers is the worst form of torture for the reps at this company.

I had already tried to register at the BC website in order to send a detailed msg of this incident, but after two hours of trying to jump through all the cyber hoops to complete the registration and trying this application at least 6 times and getting dead end msgs. I called the "problem with captcha" number on the button and learned from the representative that online registrations were not allow for Medicare recipients, so rather than posting this anywhere on their comprehensive website, they've decided to just let us folks dangle trying to do the impossible while pseudo errors are cited as appearing in their registration info & of course the members think it's their error. This lengthy description is the definition of corporate disdain. Nowhere does it state on the site that Medicare members can't register, so it seems BC has decided that their wasting a few hours trying to do the impossible is a good exercise to impart the lesson.

At this point all that's left, as intended by them, is to make another phone call - the only means of communication provided for us 2nd class members.

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Failure To Pay Bills

Posted on 02/22/2013

Rating: 1/51

LOUISVILLE, KENTUCKY -- My premiums are 400.00 dollars a month and my annual deductible is 2000.00 dollars a year. But I consistently get medical bills over 2000.00 dollars. I have MS and the medication to treat it is very expensive. One company that makes it offered it to me for free which was fine and dandy for BCBS but the medication made me sick so I could not take it anymore. The new medication my DR put me on wants payment after three months of taking it I get a bill for 4000.00 dollars. I called them and told them my deductible was 2000.00 why isn't the insurance company paying half? They said they would reach out to them after a couple of days they called me back and said BCBS told them my deductible was 4000.00 LIE. Then I applied for financial assistance they came back and said well your deductible of 4000.00 dollars has been met but your health insurance company said you should be getting your medication from another pharmacy.

Basically the one that gave me free medication that makes me sick so they have no financial responsibility. These people are greedy money hoarders and have no business in healthcare if you are sick and have BCBS you are out of luck.

I will cancel my insurance and deal with the government I can not afford to treat my illness anyway so why give them 400.00 dollars a month. Single payer please.

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Insurance companies and cost of Remicade

Posted by Donna on 02/01/2012

NORTH CAROLINA -- After 2 years of an undiagnosed illness, I was referred to a University Hospital. First visit was basic - previous history, getting new bloodwork done, etc. Second visit, doctor starts me on an infusion of drug Infliximab or "remicade". I had never heard of it, but went ahead with the process. Tiny bag - 400mg, no big deal, it was just a slow drip that was all. Went back again next month for another dose, same amount. Doctor said bloodwork looked good. I was feeling much better. Doctor says I have an immune disorder. Go again 3rd month. Feeling like a human being again. Doctor is glad I've improved. New bloodwork looks really good. BIG problem. Blue Cross sends me statement for "pharmacy" charges it will not cover for $38,000 for (2) Remicade infusions. And they still have one more bill for about $20,000 yet to send me!!. Found out the hospital failed to get a pre approval from insurance company before using this medicine on me. Several hospital officials told me, since it was the hospitals fault, I would not have to pay. The drug would just be replaced by the drug representative. Not so. My statements are now in collection agency hands
and I have to find a lawyer. I am at my wits end. Insurance company paid for everything but the medicine. Oh, I checked with a local pharmacy to see if I could by "remicade" if I had a prescription. Yes, I can, but it would be in a 100mg vial at a cost of approximately $825.00 to me. Multiply that times four and you still don't get $20,000 like the hospital was charging my insurance company for 400mg.

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They Just Don't Care

Posted by my 2 cents on 04/05/2011

ILLINOIS -- If anyone is considering BCBS, I would think twice about it. In addition to their increases annually, they also add on additional increase when your Birthday ends with an ) or a 5. In investigating options, I decided on another plan to reduce my monthly premium. When I requested an application to be sent to me, it took about a month, meanwhile my premiums has already been increased by 33%. When I sent in the new application, I waited and waited for a response. I was told in a letter I was missing a page that needed to be signed. I prompted faxed in the page. All of a sudden two weeks later I received a letter stating they are closing the application process because they did not receive my signed page. When I called them, I was told I could re-fax it, and request the application process to be re-opened. Now one would think that process should not take that long. I also requested that a rush be put on this since it was their incompetence that caused the delay. I am guessing it was that remark that put my application on the bottom of the pile. When I called 21 business days later, they said it was still being process. Not knowing what that meant, I asked to speak to a supervisor. Oh my gosh, that request takes 24 to 48 hours before one will call you back. I think I have spent more than enough time trying to get a status of my application. I was told yesterday by another supervisor, I should check in 7 to 14 business days to get a status. To add insult to injury, the supervisor ends her call with "is there anything else I can do for you today?" Seriously?, she did nothing for me today and nothing for the last 41 days when I initially sent in my application.

There has to be a company out there who will provide good health insurance, and at the same time act like they really care about their members.

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Avoid BCBS!

Posted by James on 03/26/2011

GEORGIA -- I truly hope that this message makes it to at least one person who is considering purchasing BCBS health insurance. If I can help one person avoid the headaches that have resulted from dealing with this company, it will be worth the time I took to submit this review. BCBS is a deceptive, dishonest, manipulative company that couldn't care less about members' healthcare as long as they collect the premium each month. They will raise your premium and simultaneously deny more and more of the claims that they are responsible to pay. You will pay unbelievable premiums each month, and most of the claims (be it routine office visits or prescriptions) will be denied. Trying to reach customer service is almost impossible and, when you do, you will be given a vague and nonsensical answer with no resolution.

You will be left with a simple response..."no exception." Take my word - if you are considering BCBS as your health insurance carrier, reconsider.

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Mammograms

Posted by JNYGRL on 09/22/2010

GEORGIA -- I was at a regular doctor checkup and I am 33 years old, they found a lump on my breast and referred me to have a mammogram and ultrasound to diagnose the lump, I got 2 bills one form the facility and one from the radiology clinic. BCBS paid a total of $67.00. I am paying out of pocket $500. They state a routine mammogram is paid at 100% by them. but if you have a diagnostic due to a lump or anything else they are not responsible for 100%. Why is it if you have a medical issue that is really needed to be looked at they will not pay? I think this should be looked into further and ALL mammograms should be covered by 100%, it's bad enough to go through the stress of finding a lump, then finding out you have to pay so much out of pocket when it does not state that anywhere in the benefits book. Shame on them to make one any more important than the other!

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Does not cover Mental Health???

Posted by ataloss? on 04/12/2010

We have had both of my (healthy) daughters on BCBS for many years, paying ridiculously high premiums. Last year, my oldest daughter told me she thought she had ADD. To save ourselves and BCBS, we did a study through Future Search. After free testing, my daughter was indeed diagnosed and put on ADD medicine. The changes were remarkable!!!!! She went from a B and C student to straight A's almost overnight. It also boosted her self esteem as she thought she was "dumb". After a year in the study and no out of pocket to us or our longtime Insurance carrier, we then took our first RX to be filled. To our amazement, the $156 a month medication that was Prescribed and that she had done so well on was not covered???? I informed out Dr. who then wrote a different Rx for a much less expensive medication that we could afford (no thanks to BCBS who had faithfully been taking our money every month for YEARS) but would not cover a much needed medication for our daughter. I then called to ask if we used Drugstore.com or any Mail in Rx to save money what portion would they pay. I got an extremely rude man who told me the system was down, try back in an hour or two. I asked if he could answer "general" questions about this Rx coverage. He then in formed me BCBS offers no mental Health Coverage. Wow, really. I wish I had had my daughter tested by a Physician that was not doing a study. I would have been out of pocket some money, but would have learned a year ago to quit giving money away to a Provider that does not Provide!!!! What a waste!!

I am actively searching for a different company this minute. I will let EVERYONE I come in contact with hear this story as well. When choosing a Health Plan, check into what "Mental Health" is and if it is covered. I do not believe my daughter has a Mental Health issue, but they say ADD is. I guess as just an excuse not to pay. Very sad.